Denys Lau, Ph.D., is a full-time tenure-track Assistant Professor at Northwestern University's Buehler Center on Aging. His long-term career goal is to become a funded, independent investigator in health services research that focuses on quality and safety of medication use among vulnerable and seriously-ill older adults. To achieve that goal, he seeks the Mentored Research Scientist Development Award (K01) to expand his existing knowledge in two substantive areas (palliative and hospice care treatment approaches, and family studies in the aging population) and two methodological areas (original data collection using qualitative and quantitative research techniques). This project, incorporating a tailored curriculum and mentored field experience, will generate the necessary experience and resources for Dr. Lau to submit future awardable R-01 applications. An extension of Dr. Lau's prior research on inappropriate medication use among elderly patients, the current study aims to better understand the skills necessary for effective management of medication regimens, including opioid analgesics, among informal caregivers of hospice patients living at home. Specifically, the study will: (1) develop the concept of caregiving skills in effective medication management, including a conceptual framework describing its domains and relationships with patient health status and caregiver confidence;(2) develop, refine, and validate an instrument to measure caregiving skills in effective medication management (CG-SEMM instrument);and (3) examine the relationships among caregiving skills in effective medication management, patient health status, and caregiver confidence. This career development research proposal will involve primary data collection using three techniques (focus groups, semi-structured interviews, and longitudinal survey study), and employ a mixed-method approach combining complementary qualitative and quantitative research procedures. Ensuring the appropriate use of medications among older adults is a well-recognized, important public health concern. For those older adults who rely on family members for medication assistance, a validated assessment of the skills necessary for effective medication management will help healthcare providers to screen for family members who will need further training. With family members taking on more responsibilities in caring for their loved ones, the significance of this study will be profound in improving not only the proper use of drugs for older-adult patients, but also the confidence of family members.